Managements of Patients with Coronary Vascular Disorders Flashcards
Most prevalent type of cardiovascular disease in adults
Coronary Artery Disease
Most common cause of Coronary Artery Disease
Coronary Atherosclerosis
Abnormal accumulation of lipids or fatty substances and fibrous tissue in the lining of the arterial wall vessels
Coronary Atherosclerosis
Process of fatty substances, cholesterol, cellular waste products, calcium, and fibrin building up in the inner lining of an artery leading to a reduce blood flow in the myocardium
Coronary Atherosclerosis
Coronary Atherosclerosis:
Clinical manifestations
- Angina pectoris (chest pain)
- Shortness of breath
- Palpitations
- Tachycardia
- Weakness or dizziness
- Nausea
- Sweating
Tool used to estimate the risk for having cardiac event within the next 10 years
Framingham Risk Calculator
Prevention and Management for Coronary Atherosclerosis
- Controlling cholesterol abnormalities
- Promoting cessation of tobacco use
- Managing hypertension
- Controlling diabetes
Coronary Atherosclerosis - Nursing Interventions
- Teach the client the hazards of smoking
- Encourage the following diet programs (low cholesterol, low fat, eat fish that are high in omega-3 fatty acids, increase intake of high fiber foods)
Latin for squeezing of the chest
Angina
Due to insufficient coronary blood flow resulting in decreased oxygen supply where there is an increased myocardial demand for oxygen
Angina pectoris
Causes of Angina Pectoris
- Increased metabolic demands due to strenuous exercise, exposure to cold, eating heavy meals, emotional stress, hyperthyroidism, or severe anemia
- Oxygen supplied by the blood cannot meet the metabolic demands of the muscle
- Anaerobic metabolic demands
Predictable and consistent pain that occurs on exertion and is relieved by rest
Stable angina
AKA as
- Pre-infarction angina
- Crescendo angina
- Intermittent coronary syndrome
Unstable angina
Symptoms occur more frequently and last longer than stable angina
Unstable angina
The threshold for pain is lower, and pain may occur at rest
Unstable angina
Rest and nitroglycerine do not relieve attacks
Unstable angina
Severe incapacitating chest pain
Intractable or Refractory angina
AKA “Prinzmetal’s angina”
Variant angina
Pain at rest with reversible ST-segment elevation
Variant angina
Thought to be caused by coronary artery vasospasm not of atherosclerosis, usually occurs in the cold mornings (12am - 8am)
Variant angina
Objective evidence of ischemia (such as electrocardiographic changes with a stress test) but patient reports no symptoms
Silent ischemia
Possible occurring during rapid eye movement (REM) sleep during dreaming
Nocturnal angina
Paroxysmal and occurs when client reclines, lessens when the client sits or stands up
Angina decubitus
Occurs after MI
Residual ischemia may cause episodes of angina
Post-Infarction angina
Angina pectoris - Medical Management
- Restricted activity
- Pharmacologic management
- Weight loss
- Oxygen therapy during attack
- Coronary artery bypass graft
- Percutaneous transluminal coronary angioplasty
Angina Pectoris - Nursing Interventions
- Provide physical and mental rest
- Relieve pain by administration of vasodilators
- Discourage smoking
- Health teachings regarding diet, medications, and activity
Client clenches fist over sternum when describing discomfort
Levine’s sign
Emergent situation characterized by an acute onset of myocardial ischemia that results in myocardial death
Myocardial Infarction
It is an acute necrosis of the heart muscle caused by interruption of oxygen supply to the area, resulting altered function and reduced cardiac output
Myocardial Infarction
An enzyme found mainly in the heart, brain, and skeletal muscles
CPK
An enzyme found mostly in the brain and lungs
CPK-1 (CPK-BB)
An enzyme found mostly in the heart
CPK-2 (CPK-MB)
An enzyme found mostly in the skeletal muscles
CPK-3 (CPK-MM)
A system used in individuals with an acute myocardial infarction, in order to risk stratify them
Killip Classification
Includes individuals with no clinical signs of heart failure
Killip Classification I
Includes individuals with rales or crackles in the lungs, an S3 sound, and elevated jugular venous pressure
Killip Classification II
Describes individuals with acute pulmonary edema
Killip Classification III
Describes individuals in cardiogenic shock or hypotension and evidence of peripheral vasoconstriction
Killip Classification IV
Patient has ECG evidence of acute MI with characteristic changes in 2 continuous lead on a 12 lead ECG
STEMI - ST Elevation Myocardial Infarction
There is no significant damage to the myocardium
STEMI - ST Elevation Myocardial Infarction
Patient has elevated cardiac biomarkers but no definitive ECG evidence of acute MI
NSTEMI - Non-ST Elevation Myocardial Infarction
